HomeMy WebLinkAboutGW1-2021-07817_Well Construction - GW1_20211102 WELL CONS' UC"UON RECORD Fart Lanai Use ONLY:
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1.Wdl Contractor Idormation.
Robert MillerTIN
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2675
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SAEDACCO Inc 0 h. 25 ti, 2" h6 SCE-40 PVC
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FROM 10 QtA4TE#Ett TI I K MA9EAUL
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l m 4111ap afkww r wra Pam 0("-C-Arc,514 ,'araia—e,Pow eat
VIAAfM& it#1TEt7df Ttt1 7
Water SttpN!VG'c11z FROM TO
g tt 1�2.,.,� is Ol0 SCE 9 0 PVC niAr
DAptt uhuml ONfinicip�ail lic 25
D+Gcot t(HotitagCOUM Stippty) DR+esi en ial WaMr SW1 (sinj*) �n I
DftiidustitollCattitt ial DROOentbl WOW Sl -- r
�ppf�{slcit��) sRo� � _.MA�st: `sty `_ " 1'at(vTnrtt►& `aoc�f
❑liti 'tion 0 ft. 21 IL Portland trimi
Nan—Water Supply Well. �
O11'0404P
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tlfer Stvr� a Iris gSaiinitt Rasricr _ .,.-PL
. part as. na
CIAq 23 fi. 35 p. Silica Sand 20/30
0Aquifar"Cyst ASYowmatcr DTaiwg
taPvrimantil Toelmotoy GV5e64d€ieee C.amal
2trli .,. -aiTititilia►tt '< u. : _.
[3GWdMrftW(ClasadI:oop) DT=er MOM TO a It *br.MhU *aa+►ova
OG dwtnW(Elgirte/Gaotf ReturctY Ot3tlsett inuredcr#ml ltzu>arlts) o [� 3 (t. Tan sift
3 R. 20 (i. Sandy Clay
d.ilateWA(l)Compisled. 9-15-21 WdIID#PZ-52D 20 it. 35 ti.. Tan Sand
S a.Well Location.-
Tuscarora Landfill h. (i.
FwflkOwwNam Facelii it}h tit 3gplicableD - --
7400 Old US Hwy 70 West, New Bern, NC, 28562 R p,
Pkvsmd f Mm-.t Cv.and Zip
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Craven Two foot bentonite seal from 2l'to 23'
f'cnmv Paw tdcmtln"U00 No-(P N1
Sk JA m4c and lAnghodc in d ww%1m1 tWwcoads or decimal dcgram. 22.t ertirwrdrrns
ofuril Wd,me hta;1t?r i5 sedate crd}
10/6/2021
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6.Is tart)the weli(a): UPr'artatment fir sTeniporar}
tip sVning ahisjaam,l&rrel+±•rorrlf+,+lhw.rhr nwM!rl x=dtnwa:l rraraSraxrrded Err f"u�prrdav"c:r
uizlr t�{t�YCrlf'OlC.altyt c7r X:�tYt'c9;�n�,0�tk�1h'b.tJ{`raazsfrnctftue�wn�'rrarefs arncf afaai tt
I.is bb a repair to an Wstin#WcM- OVO or MNo rfawy qfrlidr rMonf iris been prcw4W na Ow,11wi*aw7wr,
If this is a eet3a11r,fill Ow k+aanw wy rxaM2raa.W ekp,{e2rraw"Ow e+.Yft n rIN eurrare of rfw,,
repair under 021 rermums sraJ m or ran the hrm,(,af fhir j6rvL 23.Site dhW-sin or atdafi Tonal well details.
Year way to thy'back of is lop to ptttt-sde a"fimml vinell site dells or wel1
8.Ivuitvtiirra[ae1t4 oaii trradeal• 1 '^nnstnxriondeta&. You a uki dw attach 2"tioual p(tdea if i sm.,
€W OWNP1e 1hV1 e.W QOM-WaWr SW*wefts ONLY null dJO MMO ca+rstrUVfkU.YOU s-Am
sufiterareane jarred. SMUMEALlNff Cn=
9.Total w dl depth btu land wrQw 35 (ft) 24*, Ebr AliAll '4'db; Subtait this form v4iMk 30 4*,s of coutpletion of vF`4t
POP RW*f'e kilts kar dell c8rMl4s con.5hwdon to the fo kmit S;
10.Static vvrater level belay top of`casinr. (R.i 1'tMdou of Water Rtsnurem Ltnl4
1/x mpe kvd is uliceee mail «eater"}„ 1617 111a1t Service Center.hal 1.NI C 27699=1617
11,BgreB+n tl meraer.8.25" 2-4b.F'ar lnieeriaen Ub ONLY. In addition to seaading ncc foroa to the aftess,in
24a above- also subttaii a copy of ttais form within"a0 d*s of cdtaMation of%v&
12.Wdl 4.25" ESA ecautnietion to the foiiovving_ 1
hie.wXr.rams-,cabin.discs pmk cm
Ifhisipa of Water Restnircdes,Uttdctgi'aand Iajam'Not+Control Prograoi,
FOR WATER SUPPLY WELLS ONLY. 1636 Mail Service;Canny.Raleigh.NC 276"-1636
13ai.widd(wi) Mcdond of tat: 24c.for wau r Sap&, -do IPJtxthsti Wdb;
Also submit one cx py of this first mitbin:30 days of cmupieiion of
M.Diiin[ecdan by Amount: well covSum ion to that county hefalth depaoumd of the COanitV tvh=
conorncted
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